Month: May 2024

Boost Mental Well-Being for Women with ADHD: Reduce Self-Criticism and Build Self-Confidence

May is Women’s Health Month: a time to recognize and advocate for women’s physical and mental health care. Women with ADHD, and those who care for neurodivergent children, frequently deal with additional stressors, anxiety and depression, often without adequate support. At the same time, they can berate themselves for the things they are not in the face of impossible social standards laid out for females of all ages. Self-doubt frequently creeps in and plagues your ability to make decisions and feel good about your choices. Sadly, too many women with ADHD are often their harshest and loudest critics, making it tougher to feel good enough, worthy and empowered. Psychological and emotional wellness for women begins with learning to quiet that negative inner-voice, practice self-compassion and develop resilience.

The harsh feedback loop in women with ADHD

Women are socialized to please others and take care of them–emotionally, physically and psychologically. Their self-worth can be tied to what people think about them and how many friends (real or virtual) they have instead of the uniqueness of their innate talents and personal traits. In today’s busy and over-connected world, it’s easy to compare yourself to others and come up short. Suddenly you may find yourself in a cycle of negativity in the midst of scrolling your Instagram while waiting in line for a latte or for school pick-up. This self-critical feedback, generated from years of messages about missing the mark, tuning out during a conversation, or being chronically late, can be hard to shake off. Women with ADHD, already sensitive to feedback or rejection, repeatedly interpret things more negatively and personally than the situation may actually call for. They are especially vulnerable to feelings of low self-worth.

Change your relationship with the negative voice

While it’s unrealistic to eliminate negative thinking, reducing its power and influence is crucial for fostering self esteem and resilience–two key issues for women. You have to change your relationship to the negative voice: to separate actions you regret and the layer of shame you add onto them. Identify the lies that voice tells you such as: “You are stupid, you make bad choices or nobody likes you.” We all have moments when we doubt or blame ourselves. But there is a difference between what happens in real life and the stories that you tell yourself about those events. These harsh interpretations directly influence the way someone takes meaning from whatever occurred. 

Although the inner critic seems to increase insecurity and self-loathing, deep down it’s goal is to protect you and ensure you are safe. It puts you down in a misguided effort to keep you from experiencing pain from others. If you already think you aren’t good enough, then whatever anybody else says on this subject can’t hurt you. Nobody can be more critical of you than you are of yourself so you avoid the vulnerability of receiving negative feedback. This may sound confusing and even crazy but it happens for all of us.

Stumbling and regrouping is part of being human

It’s natural for all of us to stumble and make mistakes. Being accountable for an error and making amends to set things on a better course differs significantly from repeated apologies, not learning from your experience and engaging in the blame game. Your goal is to turn down the volume and intensity of that negative voice by acknowledging and accepting who you are in a given moment with whatever resources you have available. You don’t have to believe what the inner critic is saying. Instead, acknowledge the feedback loops in your mind without being ruled by them. See the inner critic as the irrational, unbalanced and demented protector it is–holding you back from taking risks and sharing your true self with the world.

Make space for confidence and resilience with a growth mindset

The most powerful tool women have to counter negative thinking is self-esteem and its cousin, resilience. Confidence empowers you to make decisions, get through life’s ups and downs and recover after setbacks. It’s your inner ally. Confidence also helps quiet the inner critic by reassuring it that your wise, inner self has the resources to meet whatever challenges you are facing. So while you’re quieting your inner critic, turn up the volume on the voice that nurtures you with compassion, kindness and support.

  1. Identify limiting core beliefs and negative self-talk. Name your limitations and the ways that you put yourself down. Then, find evidence that contradicts those beliefs. Write these down. If you believe that people don’t really like you, think about the ones who do. Recall a time when you had fun together. Write this down as a reminder. Remember that no one is judging you as harshly as you judge yourself. Talk to people in your life who love and know you best and get their perspective on all your best qualities.
  2. Separate feelings from being: Feeling bad doesn’t mean you are less than or unworthy. It may be tough, but your work is to stop letting negative feelings from defining who you are. Imagine that your mind is the sky and your thoughts and feelings are clouds that pass by. They aren’t the essence of the beautiful blue expanse of who you are. Use self-affirming phrases such as “I can feel anger without overreacting,” “I’m disappointed in myself but I’m not a bad person” or “I can try something new and handle whatever happens because I’ve done that before.” 
  3. Nurture a growth mindset approach: Shift away from trying to prove your worth to others, using false comparisons or judging yourself as less than. Transition from seeing yourself in a negative light to practicing compassion and kindness toward yourself. If you are saying something to yourself that you wouldn’t say to a third grader with a skinned knee, stop. Remember that we are all works in progress, learning and developing at our own speeds. Believe in the power of “YET.” Tell yourself, “I may not be able to do this YET, but I am learning.” Practice kindness and patience towards yourself.
  4. Create phrases of encouragement to strengthen your inner ally: Having a few helpful phrases to say to yourself can really help you get through those low moments. Positive self-talk counter-acts that negative voice so you don’t have to believe it. Build your confidence, reinforce your strengths and tame your inner critic with reminders of your gifts and traits. Sample statements might be: “Everyone makes mistakes, including me. What can I do differently next time?” OR, “There’s no such thing as perfection. It’s okay to stumble, just keep trying.” Write these down on your phone so they’re handy when you need them.
  5. Practice mindfulness and self-compassion with meditation: Picture yourself in your “happy place”–somewhere you love where you feel calm and content. Visualize the face of someone whom you love and trust. What supportive words would this person say to you? How would these words comfort and encourage you? Put your hand over your heart and send their love to you. Write these phrases down and return to these images and words whenever you need a boost. Learning how to fill up your own bucket fosters the essential resilience women need now more than ever. 

If you’ve been stuck in a pattern of knocking yourself down, learning to pull yourself back up takes A LOT of practice and grit. Learning to control the volume on that negative voice is a life skill based on persistent resilience and genuine self-esteem. It’s one step at a time so stay patient because two steps forward and one step backwards is still forward motion. 

 

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Ask Dr. Saline: How Do I Motivate Myself to Get Started on Big Projects?

overwhelmed studentDear Dr. Saline,

I’m having a hard time getting big projects at work completed on time. I do ok with smaller projects that are concrete. But when I have a longer term project that isn’t so cut and dry, I just don’t know how to get organized and get started. My ADHD has made me a professional procrastinator. So I end up pulling all-nighters and handing in my work bleary-eyed the morning it’s due. I’m exhausted and I know it’s not my best effort. I want to do better and put an end to the stress, mediocrity and disappointment. What advice do you have for how to get started on big projects and stop procrastinating?

Thanks,

Brandon

From Dr. Saline:

Dear Brandon,

Many people with ADHD struggle with productivity due to a number of executive functioning skills that relate to motivation. Whether it’s initiation, planning, organizing, time management, sustained attention or focus, it’s common to struggle with knowing where to begin an ambiguous project and watch procrastination creep in faster than a rough sea during a hurricane.

Plus, living with a Now/Not now brain, lower amounts of dopamine and norepinephrine in the brain and inconsistent attention patterns all combine to create a massive overwhelm freeze and intense avoidance. So you, like so many other folks with ADHD, put unpleasant, unclear things off until the pressure of the deadline creates a crisis mode in your brain and body. Now buoyed by adrenaline and cortisol, you rush madly to complete something, get it done but wind up depleted and exhausted afterwards. It’s a frustrating and unhealthy cycle to live with. 

Managing Ambiguity

ambiguityLet’s tackle this pattern by first looking at the impact of ambiguity on a task. Unstructured projects–whether they are for work or school–can paralyze people of all ages with ADHD. A lack of clarity about what you are supposed to do, how to proceed and where to begin can thwart the best of intentions. Plus, the ambiguity of a task makes organizing materials, planning for time and prioritizing what matters most seem impossible: it’s all just one big shapeless blob. 

Improving motivation starts by finding a reason to do something and then clarifying what needs to get done by chopping the blob into smaller parts. Interest fosters motivation so what can possibly engage you in this task? It might not be the inherent pleasure in completing it and that’s fine. How can you link doing parts of this project to something that matters to you? How can you set up small, earned rewards along the way? What are the components of this task? Do a brain dump and, once you’ve looked at what’s entailed, put items that relate to each other together.

For example, if your task is to write up summaries of client contacts that day and then categorize them, start by grouping interactions by length of sessions (short vs. long), or times when they occurred during the day (morning or afternoon). This shortens a big, unwieldy project into something manageable. 

Recently, I had to create two training sessions simultaneously: one was six hours and one was four hours. Yes, these were for my trip to Australia but that was a month away. I felt overwhelmed by these tasks. I decided to address one training at a time and start with the longer one–I needed to eat the frog, so to speak. Then I broke it down into four sections based on the breaks that the hosts had requested. Whew. I could more easily create four training sessions of one and half hours. I also like to work for 90 minute chunks before taking a break. I’d leave myself some Post-it pebbles to find my way back to what I was thinking before I stopped too.

I also found a colleague who wanted to do some Zoom co-working. These made the project seem doable. When one section was finished, I rewarded myself with a walk outside, a lunch or coffee break or talking on the phone to a supportive friend who was encouraging me. At the end of a day, instead of judging myself for what was left to do, I tried to appreciate what I had accomplished. Again, my friend and my Zoom buddy helped because we both shared. These strategies and incentives, along with the knowledge that I would feel much less anxious when the presentation was done, provided me with that key motivation I needed. 

You too can improve your motivation by starting with finding some aspect of a project that interests you. Then, armed with your reason for engagement, create helpful incentives, adjust the size of the task, pay attention to your capacity and time for focus, identify individual challenges, and emphasize progress. Put the have-to’s before the want-to’s and ask a friend or colleague to be a Zoom buddy, body double or accountability partner. By increasing motivation and decreasing ambiguity, even a little bit, you are more likely to get moving on the task at hand. 

Tips for Increasing Productivity

The following are more specific tips for ADHD adults who are looking to increase productivity. 

Reframe your view of the task

draftingThe greatest barrier to initiation is your perception of the task. You may understand the need of doing something but lack the interest, skill or focus to do it. Make tasks small enough that beginning them is within your reach. For example, instead of worrying about the entire research project, make it a goal to just work on the intro or hypothesis. Consider how long you can concentrate and for how long: then create work periods based on that information. Build in short and longer breaks, using timers and notes to get you back to what you were doing. 

Chunk it and chunk it again

postitsThe size of the task affects initiation, a critical element of motivation. If a task seems insurmountable, it’s much more difficult to start it. This is especially true for neurodivergent thinkers. So, break things down into chunks and start small.  If you still can’t begin, then the task is still too big. Make it smaller. Keep a list of three tasks on a list, either on paper or digitally, and cross each one out as you complete it. There’s so much satisfaction in knowing you’re making progress. Not surprisingly, this will also give you more motivation to keep going until the entire project is completed. You are looking for small wins to build confidence and energy so you can keep going.

Track Your Focus

In addition to initiation, focus is another important element of motivation. People with ADHD and chronic difficulties with inattention have some areas where they can pay attention with no problem. They lack attention for uninteresting tasks. 

Focus is a dynamic process of what is critical to notice or do. It is the spotlight of your attention. You can improve focus by noticing where it is and where it’s not. If you have a tendency to drift off while working or studying, create a plan for recovering focus when you catch your attention shifting away from the task at hand. It’s often helpful to create a work space for yourself which lacks distractions, like a quiet room without a TV or other digital temptations. Make it a habit to leave your phone and other devices out of arm’s reach to give yourself the best chance to stay focused on your work. 

Make Note of What’s Working

successSelf-evaluation, also known as metacognitive awareness, is the last executive functioning skill to coalesce, in the mid to late twenties for people with ADHD. Self-evaluation refers to the abilities for self-understanding, judgment and decision-making. Better self-awareness fosters academic and social competence.

As an exercise, think of what has worked well for you previously, and what didn’t when faced with a similar project. What lessons can you apply from those prior experiences to what’s in front of you right now? Create a strategy around doing more of what’s working well for you. 

It may take some trial and error to come up with an approach which works well for you. That’s ok, it’s all part of learning and maturing. Stay positive, curious, and open-minded. Now let’s roll up our sleeves and get to work!